Answers
A /72-year-old /woman /has /been /on /hydrochlorothiazide /12.5 /mg /for /many /years /to /control
/her /Stage /II /hypertension. /Her /blood /pressure /(BP) /at /this /visit /is /168/96. /She /is /currently
/complaining /of /pain /on /her /right /hip /and /on /both /knees. /She /has /increased /her /dose /of
/ibuprofen /(Motrin) /from /400 /mg /3 /times /day /(TID) /to /800 /mg /TID. /She /is /still /in /pain /and
/would /like /something /stronger. /Which /of /the /following /statements /is /the /best /explanation /of
/the /effects /of /ibuprofen /(Motrin) /on /her /disease?
A) /It /increases /the /chances /of /adverse /effects /to /her /health
B) /It /inhibits /the /effect /of /renal /prostaglandins /and /blunts /the /effectiveness /of /the /diuretic
C) /It /prolongs /the /therapeutic /effects /of /hydrochlorothiazide /and /other /diuretics
D) /None /of /the /statements /are /true /- /correct /answer(s) /✔✔ /B) /It /inhibits /the /effect /of /renal
/prostaglandins /and /blunts /the /effectiveness /of /the /diuretic.
NSAIDs /and /ASA /inhibit /the /vasodilatory /effects /of /prostaglandins, /which /predisposes /the
/kidney /to /ischemia. /NSAIDs /and /diuretics /can /cause /acute /prerenal /failure /by /decreasing
/renal /blood /flow.
2. /All /of /the /following /are /infections /that /affect /mostly /the /labia /and /vagina /except:
A) /Bacterialvaginosis
B) /Candidiasis
C) /Trichomoniasis
D) /Chlamydia /trachomatis /- /correct /answer(s) /✔✔ /D) /Chlamydia /trachomatis
,Infections /that /commonly /affect /the /labia /and /vagina /include /bacterial /vaginosis, /candidiasis,
/and /trichomoniasis. /Chlamydia /trachomatis /commonly /affects /the /cervix, /endometrial /lining
/, /fallopian /tubes, /and /pelvic /cavity.
The /nurse /practitioner /would /test /the /obturator /and /iliopsoas /muscle /to /evaluate /for:
A) /Cholecystitis
B) /Acute /appendicitis
C) /Inguinal /hernia
D) /Gastriculcer /- /correct /answer(s) /✔✔ /B) /Acute /appendicitis.
Signs /and /symptoms /of /an /acute /abdomen /include /invol- /untary /guarding, /rebound
/tenderness, /boardlike /abdomen, /and /a /positive /obtu- /rator /and /psoas /sign. /A /positive
/obturator /sign /occurs /when /pain /is /elicted /by /internal /rotation /of /the /right /hip /from /90
/degrees /hip/knee /flexion. /The /psoas /sign /is /positive /when /pain /occurs /with /passive
/extension /of /the /thigh /while /the /patient /is /lying /on /his/her /side /with /knees /extended, /or
/when /pain /occurs /with /active /flexion /of /his/her /thigh /at /the /hip.
Treatment /for /mild /preeclampsia /includes /all /of /the /following /except:
A) /Bed /rest /except /for /bathroom /privileges
B) /Close /monitoring /of /weight /and /blood /pressure
C) /Close /follow-up /of /urinary /protein, /serum /creatinine, /and /platelet /count
D) /A /prescription /of /methyldopa /(Aldomet) /to /control /blood /pressure /- /correct /answer(s) /✔✔
/D) /A /prescription /of /methyldopa /(Aldomet) /to /control /blood /pressure /
Recommended /care /for /women /diagnosed /with /preeclampsia /includes /bed /rest /with /bath-
/room /privileges, /weight /and /BP /monitoring, /and /closely /following /urine /protein /and /serum
,/protein, /creatinine, /and /platelet /counts. /Oral /medications /are /not /used /as /first-line
/treatment.
All /of /the /following /services /are /covered /under /Medicare /Part /A /except:
A) /Inpatienthospitalizations
B) /Medicines /administered /to /a /patient /while /hospitalized
C) /Nursing /home /care
D) /Surgeons /- /correct /answer(s) /✔✔ /C) /Nursing /home /care
Medicare /A /coverage /includes /inpatient /hospitalization /and /skilled /care /given /in /a /certified
/skilled /nursing /facility. /Most /nursing /home /care /is /custodial /care /(help /with /bathing,
/dressing, /using /a /bathroom, /and /eating). /This /care /is /not /covered /by /Medicare /A.
A /28-year-old /student /is /seen /in /the /school /health /clinic /with /complaints /of /a /hacking /cough
/that /is /productive /of /small /amounts /of /sputum /and /a /runny /nose. /He /does /not /take /any
/medications, /denies /any /allergies, /and /has /no /significant /medical /history. /Physical
/examination /reveals /a /low-grade /temperature /of /99.9 /degrees /Fahrenheit, /respirations /of
/16/min, /a /pulse /of /90 /beats /per /minute, /and /diffuse /fine /crackles /in /the /base /of /the /lungs. /A
/chest /radiograph /(x-ray) /shows /diffuse /infiltrates /on /the /lower /lobe /of /the /right /lung. /The
/total /white /blood /cell /count /is /10,500/uL. /What /is /the /most /likely /diagnosis?
A) /Streptococcal /pneumonia
B) /Mycoplasma /pneumonia
C) /Acute /bronchitis
D) /Legionnaires /disease /- /correct /answer(s) /✔✔ /B) /Mycoplasma /pneumonia /
, Mycoplasma /pneumonia /is /the /organism /most /com- /monly /seen /in /children /and /young
/adults. /It /is /easily /spread /from /droplets, /from /sneezing /and /coughing, /in /close /proximity.
/Diagnosis /is /based /on /symptoms /and /x-ray /results /of /infiltrates /in /lower /lobes.
A /39-year-old /migrant /worker /presents /to /the /clinic /2.5 /days /after /a /purified /protein
/derivative /(PPD) /test. /What /minimum /size /of /induration /would /be /considered /posi- /tive /for
/this /patient?
A) /3 /mm /B) /5 /mm /C) /10 /mm /D) /15 /mm /- /correct /answer(s) /✔✔ /C) /10 /mm /
The /PPD /is /administered /on /the /volar /aspect /of /the /lower /arm /and /read /48 /hours /after /the
/test /is /given. /The /PPD /result /must /have /induration /and /measure /10 /mm /or /greater /to /be
/positive /in /a /low-risk /patient. /Induration /(firmness /with /palpation) /must /be /present. /If /the
/site /has /erythema /but /no /induration, /result /would /be /negative. /Color /is /not /important.
All /of /the /following /are /correct /statements /regarding /the /role /of /the /person /named /in /a
/durable /power /of /attorney /except:
A) /The /agent's /decisions /are /legally /binding
B) /The /agent /can /make /decisions /in /other /areas /of /the /patient's /life /such /as /financial
issues
C) /The /agent /can /decide /for /the /patient /who /is /on /life /support /when /that /life /support
can /be /terminated
D) /The /patient's /spouse /has /a /right /to /override /the /agent's /decisions /- /correct /answer(s) /✔✔
/D) /The /patient's /spouse /has /a /right /to /override /the /agent's /decisions /
The /person /named /in /a /durable /power /of /attorney /(the /agent) /is /designated /by /the /patient /to
/make /all /medical /decisions, /as /well /as /any /decisions /regarding /the /patient's /private /affairs /in
/the /event /that /the /patient /becomes /incompetent /and /unable /to /make /his/her /own
/decisions. /No /one /has /the /ability /to /override /the /agent's /decision.